Evidence map›Paper›PMID 38215893›Full record

Trial reportJournal of pain and symptom management2024

Examining Moderation of Dignity Therapy Effects by Symptom Burden or Religious/Spiritual Struggles.

George Fitchett, Yingwei Yao, Linda L Emanuel, Marvin O Delgado Guay, George Handzo, Joshua Hauser, Sheri Kittelson, Sean O'Mahony, Tammie Quest, Michael Rabow and 4 more

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of pain and symptom management, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
4.3field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Spiritual care in outpatient oncology: a qualitative study of focus groups with cancer center chaplains.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  4. Testing items to screen for religious or spiritual distress in adult outpatient cancer care.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 9 institutions in 2 countries.

George FitchettDepartment of Religion, Health and Human Values (G.F.), Rush University Medical Center, Chicago, Illinois, USA. Electronic address: george_fitchett@rush.edu.
Yingwei YaoDepartment of Biobehavioral Nursing Science, College of Nursing (Y.Y., T.M.S., D.J.W.), University of Florida, Gainesville, Florida, USA.
Linda L EmanuelDepartment of Medicine (L.L.E., J.H.), Northwestern University, Chicago, Illinois, USA; Mongan Institute (L.L.E.), Harvard University, Boston, Massachusetts, USA.
Marvin O Delgado GuayDepartment of Palliative, Rehabilitation, and Integrative Medicine (M.O.D.G.), MD Anderson Cancer Institute, Houston, Texas, USA.
George HandzoHealthCare Chaplaincy Network (G.H.), New York, New York, USA.
Joshua HauserDepartment of Medicine (L.L.E., J.H.), Northwestern University, Chicago, Illinois, USA; Jesse Brown VA Medical Center (J.H.), Chicago, Illinois, USA.
Sheri KittelsonDepartment of Medicine (S.K.), University of Florida; Gainesville, Florida, USA.
Sean O'MahonyDepartment of Medicine (S.M.), Rush University Medical Center, Chicago, Illinois, USA.
Tammie QuestDepartment of Family and Preventive Medicine (T.Q.), Emory University, Atlanta, Georgia, USA.
Michael RabowDepartment of Medicine (M.R.), University of California San Francisco, San Francisco, California, USA.
Tasha M SchoppeeDepartment of Biobehavioral Nursing Science, College of Nursing (Y.Y., T.M.S., D.J.W.), University of Florida, Gainesville, Florida, USA; Community Hospice and Palliative Care (T.M.S.), Jacksonville, Florida, USA.
Sheldon SolomonDepartment of Psychology (S.S.), Skidmore College, Saratoga Springs, New York, USA.
Diana J WilkieDepartment of Biobehavioral Nursing Science, College of Nursing (Y.Y., T.M.S., D.J.W.), University of Florida, Gainesville, Florida, USA.
Harvey Max ChochinovDepartment of Psychiatry and Cancer Care Manitoba Research Institute (H.M.C.), University of Manitoba, Winnipeg, Manitoba, Canada.
University of Florida · USNorthwestern University · USRush University Medical Center · USEmory University · USHealthCare Chaplaincy Network · USResearch Manitoba · CASkidmore College · USThe University of Texas MD Anderson Cancer Center · USUniversity of California, San Francisco · US

Funding

Dignity Therapy RCT led by Nurses or Chaplains for Elderly Cancer OutpatientsR01CA200867 · NCI · UNIVERSITY OF FLORIDA · PI EMANUEL, LINDA LEAH, FITCHETT, GEORGE · 2016 to 2020
$3.2M
NCI NIH HHS R01 CA200867
6 · The paper itself

Abstract

contextDignity therapy (DT) is a well-researched psychotherapeutic intervention but it remains unclear whether symptom burden or religious/spiritual (R/S) struggles moderate DT outcomes.

objectiveTo explore the effects of symptom burden and R/S struggles on DT outcomes.

methodsThis analysis was the secondary aim of a randomized controlled trial that employed a stepped-wedge design and included 579 participants with cancer, recruited from six sites across the United States. Participants were ages 55 years and older, 59% female, 22% race other than White, and receiving outpatient specialty palliative care. Outcome measures included the seven-item dignity impact scale (DIS), and QUAL-E subscales (preparation for death; life completion); distress measures were the Edmonton Symptom Assessment Scale (ESAS-r) (symptom burden), and the Religious Spiritual Struggle Scale (RSS-14; R/S).

resultsDT effects on DIS were significant for patients with both low (P = 0.03) and moderate/high symptom burden (P = 0.001). They were significant for patients with low (P = 0.004) but not high R/S struggle (P = 0.10). Moderation effects of symptom burden (P = 0.054) and R/S struggle (P = 0.52) on DIS were not significant. DT effects on preparation and completion were not significant, neither were the moderation effects of the two distress measures.

conclusionNeither baseline symptom burden nor R/S struggle significantly moderated the effect of DT on DIS in this sample. Further study is warranted including exploration of other moderation models and development of measures sensitive to effects of DT and other end-of-life psychotherapeutic interventions.

Indexed as

Dignity TherapyNeoplasmsAmbulatory CareFemaleHumansMalePalliative CarePatientsQuality of LifeSymptom BurdencancerDignity therapypalliative carereligious/spiritual strugglesymptom burden

Identifiers

PMID38215893
PMCPMC10939845
OpenAlexW4390747384

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.